Erie doctor offers new glaucoma treatment

SIGNS OF GLAUCOMAOpen-angle glaucoma, the most common type of glaucoma, usually doesn't have early warning signs. It often develops slowly without noticeable sight loss for years.It is important to see a doctor for regular eye examinations. If glaucoma is detected during an eye exam, your eye doctor can prescribe a preventive treatment to help protect your vision.

SOURCE: Glaucoma Research Foundation

Registered nurse Kathie Walker, left, of Millcreek Township, assists ophthalmologist Robert Haverly, M.D. as Haverly installs an iStent device in the right eye of Merlyn Lindsley, 80, of Saegertown, during a procedure March 27 at Saint Vincent Hospital in Erie to help treat Lindsley's glaucoma.ANDY COLWELL/Erie Times-News

Fluid pressure inside the 80-year-old Saegertown man's right eye continued to rise, increasing his risk of blindness.

"The pressure in Merlyn's right eye was 18 to 20 (millimeters of mercury). We want it around 15 with the drops he is using," said Robert Haverly, M.D., Lindsley's ophthalmologist.

Lindsley had earlier undergone a procedure known as a trabeculectomy to reduce pressure in his left eye, but Haverly was reluctant to perform it on his right one because of the risk of complications.

Instead, the doctor implanted a stent smaller than a grain of sand inside Lindsley's eye. The iStent's job is to help fluid drain from the eye, reducing pressure and the risk of blindness from glaucoma.

"I'm excited about this," said Mildred Lindsley, Merlyn's wife and a retired nurse. "Merlyn takes the drops twice a day. It would be nice if he didn't have to take them as much."

The U.S. Food & Drug Administration approved the iStent -- the smallest medical implant ever -- in 2012, and Haverly began using them last fall.

They work best on patients who suffer moderate eye pressure that glaucoma drops can't reduce.

"It doesn't reduce the pressure as well as the other procedures, but those also have more chance of problems," Haverly said. "This gives us another option."

Haverly performed the procedure Thursday at the Saint Vincent Surgery Center in conjunction with cataract surgery. For now, the iStent is not approved as a stand-alone procedure, though Haverly expects it soon will be.

It took Haverly about 10 minutes to perform the cataract surgery, then another 10 minutes to install the iStent. He used magnifying glasses and special instruments to place the tiny stent through the trabecular meshwork of tissue along the outer edge of the iris.

The iStent creates a permanent opening in the meshwork, allowing fluid to more easily pass out of the eye through the Schlemm's canal and reduce eye pressure.

"Left untreated, increased pressure in the eye can cause nerve damage and lead to blindness," Haverly said. "Reducing pressure is the way we treat glaucoma."

It will take about a week for Lindsley to notice a reduction in eye pressure. He will continue to take his glaucoma drops until Haverly determines whether he can reduce or stop them.

"Anything that helps will be better," said Lindsley, who also suffers from macular degeneration.

DAVID BRUCE can be reached at 870-1736 or by e-mail. Follow him on Twitter at twitter.com/ETNbruce.

SIGNS OF GLAUCOMAOpen-angle glaucoma, the most common type of glaucoma, usually doesn't have early warning signs. It often develops slowly without noticeable sight loss for years.It is important to see a doctor for regular eye examinations. If glaucoma is detected during an eye exam, your eye doctor can prescribe a preventive treatment to help protect your vision.